Things to Know about Small Fiber Neuropathy
Small fiber sensory neuropathy is a neuromuscular disorder that leads to a tingling sensation in the feet and then slowly travels through the rest of the body. This condition is a type of peripheral neuropathy, which means that it affects the peripheral nervous system of the body. Other conditions in peripheral neuropathy can affect nerves outside the brain and also the spinal cord. Let us understand small fiber sensory neuropathy and its treatment options better.
Causes
This is a condition that occurs when the small fibers of the peripheral nervous system get damaged. These are the nerves that carry pain, temperature, and other related symptoms to the brain or the spine, and they are also responsible for controlling digestion, heart rate, and blood pressure. These damaged nerves affect the sensory nerves, sweat glands, blood vessels, gastrointestinal system, and also the heart.
It is understood that often those experiencing small fiber neuropathy also have diabetes, which could be a cause of this condition. Other conditions that may cause this disease include fabry disease, hypothyroidism, endocrine and metabolic disorder, hereditary disease, metabolic syndrome, hereditary amyloidosis, tangier disease, immune system disorders, psoriasis, rheumatoid arthritis, sarcoidosis, inflammatory bowel disease, celiac disease, Gullain-Barre syndrome, lupus, HIV, Lyme disease, vasculitis, infectious diseases, Sjogren’s syndrome, scleroderma, mixed connective tissue disease, and hepatitis C. B12 deficiency could lead to this condition, and side effects from chemotherapy treatment may also be responsible. It is understood that when an underlying cause is not found for this condition, it is termed idiopathic.
Symptoms
While symptoms may vary, the pain remains the most common one among all. It starts at the feet first and then slowly travels through the body, and one might notice these symptoms in hands as well; this is known as the stocking and glove distribution. Some other common symptoms to know include loss of sensation, short bursts of pain, and a tingling, prickling, or burning sensation.
In some cases, the feet touching the bed sheet or socks touching the feet may also lead to some pain. The symptoms start as mild and gradually get severe if not diagnosed and treated properly. It can affect other bodily functions and show symptoms like constipation, difficulty sweating, dizziness, dry eyes, incontinence, sexual dysfunction, skin discoloration, and dry mouth.
These are part of the body’s autonomic functions, which include regulation of blood pressure, digestion, and urinary function.
Risk factors
Anyone who has any of the above-mentioned underlying conditions is at a higher risk of developing this disease, especially those with diabetes. According to research, it is studied that 50 percent of those suffering from diabetes will eventually develop neuropathy in their lifetime, so diabetics need to be more aware. When there is no underlying cause of small fiber neuropathy, it is observed that the individuals still had some amount of glucose intolerance which is usually associated with prediabetes. Also, this is a condition noticed in men more than women and those who are aged above 65 years old.
Diagnosis
Individuals may have to go through various tests to diagnose the condition properly. Some of these tests include knowing the full health history of the patient, which involves personal questions about symptoms experienced and any family history which may be connected. These FAQs will identify some known or unknown conditions which affect this disease. Other tests include:
Nerve conduction test and electromyography
This is more of an elimination test to check if the individual is experiencing any large fiber peripheral neuropathies as the symptoms are similar to small fiber neuropathy. Once the tests are done and the result comes out to be normal, further testing is done to narrow down the diagnosis.
Skin biopsy
This is known to be the most effective way of diagnosing small fiber sensory neuropathy. The biopsy is only mildly invasive and the process involves taking several small skin samples from the legs to examine under a microscope. This close examination gives a better understanding of any signs of nerve damage.
Reflex testing
It is also known as the Quantitative Sudomotor Axon Reflex Testing, which tests the autonomic functions in the body. These are the functions that regulate blood pressure, digestion, and urinary functions. The test uses a mild electric shock therapy, which is given to the patient to observe the amount of sweat produced from the activity. If the sweat output is lower than average, then it is understood to be small fiber neuropathy.
Apart from these tests, the doctor may also recommend others like genetic testing, imaging tests, or even some blood tests to be sure of the diagnosis.
Treatment options
The treatment mostly depends on the underlying condition that is causing this disease. If the individual is diagnosed with diabetes, then the treatment method includes managing blood sugar levels and maintaining a healthy waist to hip ratio. If the underlying condition is something else, then the treatment is changed to cater to those specific symptoms.
When the small fiber neuropathy is identified to be idiopathic, then the treatment options are recommended to manage the symptoms and not treat the disease as there is no underlying cause. This can include using topical pain creams and even analgesics.
Management
Anyone diagnosed with this condition mostly learns to manage the pain throughout their lifetime unless there is an underlying cause and treatment is done to cure the disease. However, it should also be noted that while the symptoms gradually get severe from mild, small fiber neuropathy doesn’t need to lead to large fiber neuropathy.
When the pain becomes too difficult to manage and disrupts everyday life, like walking and working, the individual is eligible for disability allowance under the Social Security Association guidelines. There are several other factors to consider; however, a good attorney will be able to answer all the questions about the same.
